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Interpositional tricortical iliac bone graft in nonunion of midshaft clavicular fractures

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Author(s)
Eun-Seok SonBum-Soon ParkChang-Jin YonChul-Hyun Cho
Keimyung Author(s)
Son, Eun SeokYon, Chang JinCho, Chul Hyun
Department
Dept. of Orthopedic Surgery (정형외과학)
Journal Title
J Musculoskelet Trauma
Issued Date
2025
Volume
38
Issue
1
Keyword
ClavicleBone fracturesMidshaftNonunionBone transplantation
Abstract
Background:
The purpose of this study was to investigate the radiological and clinical outcomes after interpositional tricortical iliac bone graft with plate fixation for the nonunion of clavicle midshaft fractures.

Methods:
Between 2007 and 2020, 17 cases who were treated by interpositional tricortical iliac bone graft with plate fixation for the clavicle midshaft nonunion combined with bone defect were investigated. The mean age was 53 years (range, 22‒70 years). The mean follow-up period was 102.2 months (range, 18‒193 months). Serial plain radiographs were used to evaluate radiological outcomes. The University of California, Los Angeles (UCLA) score, American Shoulder and Elbow Surgeons (ASES) score, and Quick-disabilities of the arm, shoulder, and hand (DASH) score were used to evaluate clinical outcomes. Complications were also evaluated.

Results:
All cases achieved complete bony union with mean healing time of 17.6 weeks (range, 14‒22 weeks). The mean clavicle length difference was significantly decreased from 9.1 mm preoperatively to 2.6 mm postoperatively (P<0.001). The mean UCLA and ASES scores were significantly improved from 18.1 and 52.2 before surgery to 30.6 and 88.6 after surgery (both P<0.001), respectively. The mean final Quick-DASH score was 18.0. Three cases (17.6%) developed postoperative complications including two cases of shoulder stiffness and one case of screw irritation.

Conclusions:
Interpositional tricortical iliac bone graft with plate fixation for the clavicle midshaft nonunion demonstrated excellent radiological and clinical outcomes. In cases of atrophic nonunion combined with bone defect, this technique is an effective option that can provide structural support and restore clavicle length.
Keimyung Author(s)(Kor)
손은석
연창진
조철현
Publisher
School of Medicine (의과대학)
Type
Article
ISSN
3058-6275
Source
https://e-jmt.org/journal/view.php?doi=10.12671/jmt.2025.00004
DOI
10.12671/jmt.2025.00004
URI
https://kumel.medlib.dsmc.or.kr/handle/2015.oak/45981
Appears in Collections:
1. School of Medicine (의과대학) > Dept. of Orthopedic Surgery (정형외과학)
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